Frequency of Vital signs

[traumakimi]

Hi everyone.

I just finished a study on monitoring vital signs in the ER. I had LOTS of missing temps.

how often do you repeat temps in your ER on "regular" ER patients and on boarders?

Thanks for your input!

[Altra, BSN, RN]

On a "regular" ER patient: temp obtained only once, unless they've been given an anti-pyretic. And even then - if it's a low-acuity urgent-care type of patient and it's a day with quick door-to-discharge time, they may well be discharged before the 2 hr. point when it would be reasonable to reassess the effect of the anti-pyretic.

On "boarders" : upon reassessment by new nurse after shift change, again unless they've been given an anti-pyretic.

I'm excluding patients who are being cooled s/p arrest or s/p neuro injury.

[nurse2033, MSN, RN]

Not very often. Every patient gets a temp with vitals at triage. We only repeat if there is a reason to do so. But for the majority of patients with a normal temp they don't get another.

[Esme12, ASN, BSN, RN]

I agree with everyone ........the only time temps are repeated in the ED in addition to everyone else is in the setting of hypothermia also.

[mackjazz, BSN, RN]

Your hospital may have a policy on how often to repeat vital signs in the ED. Regardless, you should use your best nursing judgement on each patient. I dont like to exceed 2 hours without a set of vitals on anyone. As for the temp, I repeat if appropriate.

[MassED, BSN, RN]

if patients come in with a "regular" illness (ankle injury, chest pain) - not febrile illness related, I don't recheck a temp. If it's a febrile illness, then obviously you'll recheck. Normal non-critical patient q 2 hours. Critical patient, q 5 minutes in our critical care area. But no temps except on admission, if we can. Boarders and psych, q shift. Unless there's a change in their status. Definitely have to have VS before discharge.

[traumakimi]

Thanks everyone. I'm glad to see that everyone has the same basic policy. I'm finishing my dissertation and it focuses on the frequency of vitals in the ED and how it's affected by crowding. In my literature review i didn't find many research article on the frequency of vitals (except with post ops and inpatients). The hospital where i did my study had a policy, and i figured that other hospitals would also, but I wanted to see what you all thought.

Thanks for your responses! I appreciate it!

[canoehead, BSN, RN]

Q4H is policy, but I don't wake people. They rarely get more than 4 hours sleep at a stretch anyway.

[mcknis]

Yep just once and then per diem from there!

[Gurmo]

Temporal temp reads takes a mere seconds. I usually grab one on discharge and one triage.